GSM: Understanding Vaginal & Bladder Symptoms from Hormonal Shifts

You’re not imagining it.
Your body feels different — dryness, irritation, discomfort during sex, maybe even leaking when you laugh or an increased need to run to the bathroom.

And yet, every time you bring it up, you’re told “everything looks normal.”

But something has definitely changed — and the cause may be something many doctors don’t talk about enough: hormonal shifts that affect your vaginal and bladder tissues.

At InTouch Primary Care, we help women connect the dots between hormone levels and symptoms often misdiagnosed as infections or “normal aging.”

Hormonal Changes Affect More Than You Think

These symptoms aren’t just for women in menopause. You might be in your 30s or 40s, on birth control, breastfeeding, or recovering from treatment for breast cancer. Hormonal changes can happen in many situations — and they often bring noticeable discomfort.

This set of symptoms is medically known as Genitourinary Syndrome of Menopause (GSM), but the simpler explanation is this: when estrogen, progesterone, and testosterone levels drop, your vaginal and urinary tissues change.

That can mean:

• Less moisture and elasticity
• Increased sensitivity or irritation
• Greater risk of discomfort, UTIs, or leaks

Symptoms to Watch For

These changes can vary, but common vaginal symptoms include:

• Dryness or loss of lubrication
• Itching, burning, or irritation
• Pain during intimacy
• A feeling of tearing or tightness
• Light bleeding after sex

Bladder-related changes might include:

• Frequent or urgent urination
• Burning with urination (without infection)
• Recurring urinary tract infections
• Leaking when coughing or laughing

If you’ve had repeat yeast infections or UTIs without clear results, hormone-related tissue changes may be the true cause.

Common Triggers of Hormonal Shifts

Hormone-related vaginal and bladder symptoms can be triggered by:

• Birth control pills
• Breastfeeding
• Breast cancer treatments (e.g., tamoxifen or aromatase inhibitors)
• Surgical menopause (removal of ovaries)
• Infertility treatment
• Eating disorders or major weight changes
• Chronic stress

Even without menopause, your hormone levels may dip enough to create these changes — and the symptoms are very real.

You Have Options — And They Work

The good news? You don’t have to live with these symptoms. Treatment is available, and we walk you through every step.

At InTouch Primary Care, we offer a personalized, step-by-step approach to help you feel better.

Step 1: Evaluation

We start with a thorough history, symptom review, and a gentle pelvic exam if needed to understand what’s going on.

Step 2: Tailored Treatment Options

Your plan may include hormone or non-hormone options, depending on your goals and medical history.

Local hormonal treatments (very low-dose and safe) may include:

• Estradiol creams or vaginal tablets
• Vaginal rings (like Estring)
• Intrarosa (DHEA) or Osphena (oral option)

Non-hormonal supports include:

• Moisturizers (like Replens or Good Clean Love)
• Lubricants (especially silicone-based for lasting comfort)
• Pelvic floor therapy
• Lifestyle adjustments (hydration, stress reduction, nutritional support)

Safety & Libido

There’s often confusion around hormone safety. Here’s what we want you to know:
Local vaginal hormone therapies are safe for most women — including many with a history of breast cancer. They work right at the tissue level and aren’t absorbed systemically in large amounts.
They also support comfort and intimacy. When the tissue is healthier, sex becomes more comfortable.

You’re Not Alone — And You Deserve Relief

Too many women are told “it’s just aging” or “nothing’s wrong” — but that’s not the whole story.

• You are not too young.
• Your symptoms are real.
• Relief is possible — with the right care.

If you’ve been struggling in silence, or haven’t found answers yet, we’re here to help.

Ready to Feel Like Yourself Again?

We invite you to schedule a personalized visit with us. At InTouch Primary Care, we specialize in helping women feel comfortable, confident, and well-informed about their care.

Visit InTouchPrimaryCare.com or call our office today to book your consultation.

Let’s connect the dots and find a plan that works for you.